Kate Dernocoeur

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Hands On


This article appeared in the May/June 1992 issue of Rescue Magazine as part of the column known as "Nuggets" which ran from 1988-1992.


People in the rescue business are given permission to do a lot of otherwise unacceptable things, like sometimes driving the wrong way on a one-way street or jumping from high places (with rope protection). The public trusts us to know how to lend some control to the chaos of crisis.

One of the most personal liberties given rescuers can be seen on virtually every rescue call: The medical provider actually touches someone else—from head to toe. Everywhere. Every day, people in need submit to total strangers, actually welcoming this relatively gross invasion of space; they realize that someone knows what to do about the situation.

But it took me a long time to fully appreciate that there is another element to the skill of touching that is completely separate from the quick once-over of a head-to-toe survey or from subsequent splinting, bandaging, extrication and other rescue work. I call it touching with compassion—that gentle, strength-giving, non-verbal expression that says to the victim, "We're here; we know this is hard for you, and we can help." Give it an honest try, and you are likely to find the value.

It took me longer still to gather the courage to touch strangers in this way. You see, just like everyone else, I have emotional baggage from my childhood. One load has to do with closeness; when I was little, we weren't a very touching, hugging group. In fact, keeping more than an arm's distance from other people seemed the safest way to proceed with life.

When I became a paramedic and saw some of the best paramedics at work, I noticed that they were able to soothe and settle frightened, excited, even angry patients—simply through the art of touching with compassion. It was so effective that I knew I had to learn how to do it. That was when I realized that much of what we consider to be inborn talent is actually more the result of devoting the time and effort (and risk, in my case) to learning important skills and techniques.

Learning to touch with compassion was risky for me for two reasons. First, I had to overcome our widespread cultural habit of keeping our hands off each other except in the most personal relationships. It's a hands-off world out there, and someone who does much more touching than a brief handshake is often viewed with suspicion by non-touchers. I had to keep telling myself that medical emergencies are the exception.

And I was right. As I tried the skill and then improved it, I learned that people in crisis often want to be touched—even held—the way they were when they were being comforted as children. You'll learn it too if you are brave enough to try.

The second risk I faced when I was learning to touch with compassion involved overcoming my fear of reprisal. As a child, I had learned that getting close could be hurtful. What would it be like to use an interpersonal communication tactic that exposed me to so much risk? What if patients reacted negatively? What if, in the process of learning, I offended someone or made an uncomfortable situation even worse? I had to come to grips with the idea that my own experience was long since past and that I had the choice to unload that old baggage. So I did it for the sake of my patients (or so I initially thought).

What I learned is that it is important to be able to expertly "read" other people. Some people are like I used to be: frightened of or resistant to this kind of care. Trying to impose something so personal on them can interfere with a responder's effective handling of the situation. But I learned that in the majority of cases, people benefit from being touched. They are helped when I hold a hand or elbow, pat a knee or even hug them.

I also discovered that acquiring this skill involves a rather awkward learning curve. Touching to show warmth and caring requires a naturalness that just is not there the first dozen tries. To even try it at all, I had to bargain with myself that, in order to see if the skill was as valuable as I predicted it would be, I'd try it until I felt comfortable doing it. Then, if there was no value, I could quit. There was an endpoint to the anxiety of trying.

Thus, with sweaty palms and increased pulse rate, I tried attaching my hand (rather woodenly) to people's knees and shoulders (the "safe" places). It was hard—and very frightening. But then I began to relax. It got easier. I got better at it. And the results were astounding. The (not so) simple learning of this one skill led to improved rapport with patients. They were easier to calm and more cooperative. They trusted me to choose the right mode of care for them. They thanked me with all sincerity because we had shared more than a straight business relationship. I had not simply taken them from point A to point B in a special vehicle; I had touched their lives in a vulnerable moment—and I knew that the physical touch had helped create the connection.

Learning the skill of touching with compassion—a far different skill from a medically oriented head-to-toe survey—has given me benefits I never dreamed imaginable. Hugs are known to instill self-worth and self-esteem, and they are one small way to dissipate stress. The goodness that is transmitted through holding a hand or linking elbows is real. And now, these gifts are available to me every day, in my work and in my personal life.

My patients (and to my credit, my patience at learning a scary skill) gave this to me. If you haven't given yourself a new rescue tool lately, why not try this one?